Drifting off to sleep when you have neck pain can be a pain in the... you get it. Worse, it can be triggered every time you adjust your sleep position, especially if you’re tossing and turning.
How do you keep your head supported? What can you be doing to prevent pain and make sure your range of motion is intact?
Beyond mobility, neck pain — an issue faced by millions of people worldwide — is associated with mild to severe insomnia. Research shows 54% of people who develop neck pain report insomnia while 22.9% possibly experience clinically significant insomnia. This pain, which can be caused by an acute issue (like an injury) or chronic condition (such as arthritis), ranges from a stiff achiness to a sharp shooting pain.
“Neck pain can come on gradually and increase over time, or you can just wake up in the morning and not be able to move your neck,” says Kelly Greenway, DPT, a physical therapist and clinic director at FX Physical Therapy in Maryland and Virginia.
What’s more, the way your head hits the pillow may aggravate your neck pain further — making it even harder to fall asleep or get quality sleep. It’s a frustrating cycle, but the good news is that you can break it with the right tools and techniques.
Here are some things you can do to sleep better if neck pain keeps you up at night, or ruins how you feel in the morning.
Find the right sleeping position (Hint: It’s not your stomach)
When it comes to getting decent sleep with neck pain, the key is finding a position that keeps your spine straight. Opt for sleeping on your back or side, rather than on your stomach.
“With neck pain, sleeping on your stomach should be avoided as the neck will crane forward with excess pressure, which leads to improper alignment and can worsen the pain,” says Dr. Rahul Shah, a board-certified orthopedic spine surgeon and partner with Premier Orthopaedic Associates in New Jersey.
If you’re a back sleeper, keeping your hands at your side or resting them on your chest could help reduce neck pain and lead to better sleep, research shows.
Side sleeping also works well because it helps align the neck with the middle of the spine, easing pressure in painful areas. Avoid tucking in your chin though, as this puts your head forward and can further strain the neck.
Consider what material your pillow is made from
Finding the right support, comfort, height, and shape can help reduce neck fatigue. One 2020 study found that pillows shaped with a flat horizontal plane pillows and gentle vertical curve scored higher for less neck and shoulder pain. The same study also found that latex and memory foam provided better support for adults’ necks.
A pillow that is too high or inflexible may also strain your neck, especially if you’re a side sleeper. If your pillow also doesn’t return to form after you lift your head, it may be time to get a new pillow.
Put pillows in the right places
Putting pillows in all the right places can also support your neck and spine, helping ease neck pain and promote sleep.
For back sleepers, that means one pillow that keeps your head and neck in line with your spine, says Greenway. To prevent additional strain, consider using a few pillows (from one to three) under the thighs and knees to prevent arching your low back.
“For those who sleep on their backs, a cervical pillow can help the neck stay in a neutral position in conjunction with a firm enough mattress to avoid sinking,” Shah adds.
Prefer to sleep on your side? Just like back sleepers, side sleepers with neck pain should also use a pillow to keep their head propped enough to align with their spines, without overly elevating them.
“You want to avoid your head tilting down towards the bed or up toward the ceiling,” Greenway explains. “You can also hug a pillow at night to support your top shoulder and prevent your shoulder from rolling too far forward.”
Limit your screen time to avoid “tech neck”
You’ve likely heard that putting the phone down before bed helps you avoid exposure to blue light. But if you’ve got neck pain, there’s even more reason to monitor your screen use — and your posture while you do it.
“The more that your head comes forward, the more weight and load that is placed through your neck. This weight can be up to 40 to 60 pounds on your neck! This will irritate the joints and muscles in your neck,” says Greenway.
Keeping screen time to a minimum can help lessen the strain on your neck (dubbed “tech neck”) that can come from hunching over a computer or phone for hours on end.
When you do need to scroll, try to maintain a posture that keeps your neck straight. Keep your shoulders down and back, your ears aligned with the tips of your shoulders, and your devices at head level so you don’t need to hunch over and strain your neck, Greenway explains. (For tips, read below.)
Strengthen your neck and upper body muscles
Stretching your neck muscles can help decrease neck pain in general, which can make dozing off easier. To ward off neck pain, try gently turning your neck from left to right while keeping your chin level and holding for about 20 seconds, four times a week, says Shah.
Incorporating regular stretches and strengthening exercises that target your upper body throughout the week could also lead to long-term reductions in pain.
“A combination of strength exercises, such as lifting dumbbells, and aerobic movement, such as walking or running, will put one's back and neck in optimal alignment,” Shah adds. “Any activity that increases blood flow to all of the muscles can help with back and neck discomfort.”
Always consult with a physical therapist or healthcare professional to make sure these types of movements are safe for you before trying them. And if any stretch or exercise causes sharp or electric pain, stop doing it and check in with a doctor.
Other ways to help relieve neck pain
- Make sure you have an ergonomic workstation. When your computer isn’t at eye level, you may start to look down more frequently, causing your head to tilt forward and strain your neck. Use books or boxes to help prop up your monitor, and if you use a laptop, get a separate keyboard.
- Relaxation techniques: Holding tension in your body can create or worsen neck pain. Stress-reduction techniques, like meditation or massage, can alleviate tension in your neck muscles and get you relaxed before bedtime.
- Hot and cold therapy: Using an ice pack on your neck for up to 20 minutes a few times throughout the day can help your neck hurt less. You can also relax your neck muscles before bed with a heating pad or a hot bath.
- Medications: Taking over-the-counter pain relief medication short-term can help reduce discomfort from a neck injury or another acute pain issue. A healthcare professional can also prescribe other medications to soothe neck pain and help you sleep better, if necessary.
Besides attending to your neck’s needs, make sure you have set yourself up for sleepy success. Restorative sleep is one of the best ways to manage neck pain and ensure continued good sleep. In fact, research shows that not getting enough sleep causes your pain threshold to go down, which can cause anticipatory anxiety that keeps you up. Your chances of improving neck pain also goes down with poor quality sleep.
In other words, your neck pain may feel worse because you’re not sleeping well — so take stock of your sleep hygiene and other bedtime habits to help give your neck pain a break.
Still can’t get to sleep? You may want to connect with a healthcare professional, such as a physical therapist, sleep specialist, or your family doctor, to determine and address if there’s another underlying cause of your neck pain and sleeplessness.
